Date of event:______________
I am entering:
_______ 3-Phase Division:_________________ $65
_______ 2-Phase (Dressage & Stadium) Level:_______________$50
_______ Dressage(one phase) $20 per test, test:________________________
_______ Mix & Match division, $70 (choose your test and fences below)
Dressage:_____________ X/C:___________ Stadium:________
_______ Leadline: $20
Number deposit $2, to be refunded upon return of numbers.
Lunch will be available for purchase, don't miss Billy's Bar-b-que special of the day!
Division:__________________________________ Jr. ____ Sr. ____
Rider:_________________________________Horse:_____________________
Breed:_________________________ Color:_________________ Sex:___________ Age:______
Age of rider (if under 21):____ Telephone #:_________________________
Address:___________________________________
email:_____________________________________
Entries will only be accepted with completed entry form, full payment and signature. Proof of 2015 negative coggins test must be presented on day of event or sent with entry. Visa/ Mastercard entries accepted by telephone 802-468-2200 or fax 802-468-2151.
Entry Fees:_________, additional test(s):_____________, & # deposit:__$2__.
If renting a lesson horse for the day add an additional $20.
Truck-ins renting a stall for the day add an additional $20, please leave stall clean.
I enclose a total of $______________ for aforementioned entry, which is made at my own risk. In addition, I assume all the risks resulting from participation in this competition, and I will hold harmless Horse Amour and all persons associated therewith, from any and all liability action, causes of action, claims, and demands of any kind and nature whatsoever which may arise in connection with or resulting from participation in any of their activities. I have read and understand the rules of this competition.
Signature of entrant:_______________________________
Signature of parent (if underage):____________________________
Make checks payable to "Horse Amour" and mail to:
Horse Amour
804 Eaton Hill East
Castleton, VT 05735
No entries will be accepted w/o payment in full. Sorry, NO exceptions in 2015!!!!
